The most common type of oncological skin pathology is basalioma on the face, which is a basal cell carcinoma, basal cell carcinoma. This tumor neoplasm takes its beginning in the germinal epithelial layer. The most characteristic features for basalioma are slow growth and very rare metastasis. Most oncologists prefer to attribute such a tumor process to semi-malignant neoplasms.
Description of pathology
Basal cell carcinoma is distinguished by its persistent recurrent course. Quite often, invasion occurs in almost all skin layers, including the deepest ones. This process can cause cosmetic functional defects on the surface of the skin. People of different ages are exposed to diseases, however, according to statistics, every fourth person before and after50 years old who is sensitive to sun exposure and has fair skin.
Provoking factors
Factors that can provoke the development of basalioma on the face include:
- solar exposure;
- ionizing factor;
- exposure to substances of a chemical nature, for example, arsenic, hydrocarbon derivatives;
- frequent injury to the skin.
Basal cell carcinoma originates in the deep layer of the skin. After that, its gradual germination to the superficial areas of the skin begins.
Signs
Basalioma (photo below) can manifest itself in several clinical forms:
- Nodular-ulcerative. This form is most often localized on the inner surface in the corners of the eyes, on the surface of the eyelids, in the nasolabial folds. Above the skin, such a basalioma appears as a red or pink dense formation of a nodular shape. The surface of the formation is shiny. Gradually increasing, the node begins to ulcerate, a greasy coating forms at the bottom of the ulcer. On the surface of the node, characteristic vascular expansions (telangiectasias) are formed. It is also possible the appearance of a crust, which is surrounded by a dense pearl-colored roller.
- Perforating basalioma on the face. This form of basal cell carcinoma is quite rare, it is characterized by a very rapid infiltration. Its appearance practically does not differ from the nodular-ulcerative form of basalioma.
- Exophytic, warty, papillary. Basalioma data on the skin surfaceappear in the form of dense rounded nodules that resemble cauliflower in appearance. This form is not characterized by infiltration.
- Large nodular nodular. This tumor is characterized by a single localization of the nodular neoplasm. Signs of telangiectasia are clearly visible on the surface.
- Pigmentary basalioma (there is a photo in the article). The appearance of such a neoplasm is very similar to melanoma. The main difference is that the node has a dark internal pigmentation, a pearl-colored roller surrounds it.
- Atrophic cicatricial. The shape of such a basalioma is flat, ulcerated, surrounded by a dense cushion that has a pearl color. A characteristic difference of this form of basal cell carcinoma is that the erosive spot grows at the moment when scarring occurs in the center.
- Sclerodermiform basal cell carcinoma. Prone to scarring and ulceration. The initial stages of development are characterized by the appearance of small dense nodes, which quickly transform into flat, dense spots with vascular translucence.
- Pagetoid superficial tumor. This form of basalioma on the face is characterized by the appearance of many neoplasms that have a flat shape. Tumors reach quite large sizes. In this case, the plaques have raised edges that do not rise above the skin. The color can be represented by any shade of scarlet. Quite often, it is accompanied by the appearance of various diffuse processes, for example, in the form of a cyst in the lower jaw area.
- Turbanbasalioma. It affects only the scalp. Its color is violet-pink, the base is wide, about 10 centimeters. The development process takes a long time. The clinical picture is benign.
Basalioma stages
Classification of pathology by stages is based on the characteristics that appear in the clinical picture, such as the area of the lesion, the depth of germination, signs of destruction, and others. In accordance with these characteristics, it is customary to distinguish four stages of basal cell carcinoma:
- The initial stage of basalioma is characterized by the appearance of neoplasms, the size of which is no more than two centimeters. They are locally limited and did not have time to grow into neighboring tissues.
- Nodular tumors, the size of which is more than two centimeters, belong to the second stage of the disease. There are signs that the basalioma has grown into all layers of the skin, but the fatty tissue remained unaffected.
- Neoplasms measuring three or more centimeters belong to the third stage. At this stage of development, the tumor grows to the bone.
- Basaliomas of the fourth stage are neoplasms that affect the bone and cartilage tissue.
Signs of the initial stage of basalioma
A characteristic feature of the tumor is its location in different areas of the neck and face. Localized on the skin of the nose, which is also not uncommon. At the very beginning, the tumor manifests itself in the form of small and painless nodules that match the color of the skin. Most often they appear on the forehead or innasolabial folds and resemble ordinary acne.
At the initial stage, the basalioma looks like a small pearly nodular formation. After a while, it begins to get wet, and a crust begins to form on the surface, through which you can distinguish the ulcerated surface.
Pain and discomfort are absent. Such nodules can appear in whole groups and then merge into one. As a result, an angiitis plaque is formed, which has a lobed surface. That's what a basalioma is.
Characteristic
A characteristic feature is that telangiectasic signs appear on the surface of the plaque, that is, stains formed by small capillaries. After some time, a bubble edging is formed along the perimeter of the formation, which then turns into a edging of a dense structure. It is this roller that is a characteristic feature of basal cell carcinoma. If you try to stretch the skin at the site of the neoplasm, you will clearly see the ring of inflammation, which has a red color.
Tissue breakdown on the surface of the tumor provokes an erosive or ulcerative process. If you remove the crust covering the ulcer, it will reveal a recess in the form of a crater or an uneven bottom. Such tumors may be partially scarred, covered with crusts, but, despite this, continue to grow slowly, without causing any discomfort.
Slow growth reveals disease in 80% of patients. At the same time, if the disease is detected in a timely manner, then the prognosis is very favorable: in 98% of cases, the disease can be completely cured.
Treatment of basalioma on the face with folk remedies is used, but only at the initial stage and in combination with other methods.
Late disease development
The late period of development of carcinoma is characterized by its germination in the deep layers of the skin, resulting in a depression in the form of a crater. The structure of ulceration becomes dense and ceases to shift to the side during examination. The bottom of the wound becomes oily and shiny, the ulcer itself is surrounded by clearly visible capillaries.
As we have already mentioned, basal cell carcinoma develops over a long period and is characterized by growth in depth, and not in area. In this regard, after the treatment of basalioma in the later stages, patients have a very noticeable cosmetic defect, which is difficult to correct later.
Many patients have recurrent carcinoma.
The risk of basalioma and the need to remove it
The long process of tumor development provokes its penetration deep into the body, resulting in damage and destruction of soft tissues, bones and cartilage. Cellular growth of the neoplasm occurs along the nerve fibers, inside the layers of tissues and along the surface of the periosteum.
If basal cell carcinoma is not removed in a timely manner, destruction will affect not only tissue structures.
Complications
Basalioma can disfigure and deform the nose and ears as a result of the destruction of bone and cartilage tissue. The course of the disease may be exacerbated byprocess, to which it is possible to attach a variety of infections. In addition, it is possible:
- lesion of the mucous membranes in the nose;
- transition of the tumor process into the oral cavity;
- damage and destruction of the bone tissue of the cranium;
- eye socket damage;
- appearance of blindness and deafness.
The introduction of a tumor into the skull, which occurs through natural cavities and holes, is especially dangerous.
In such cases, brain damage and subsequent death of the patient become inevitable. Despite the fact that basalioma is considered a non-metastasizing tumor, there are about two hundred described cases that it did metastasize.
Let's consider how the treatment of basalioma on the face is carried out.
Treatment of basal cell carcinoma
Treatment techniques include:
- Drug therapy with local chemotherapy using cytotoxic drugs, such as Cyclophosphamide. It is also possible to use applications with Fluorouracil and Methotrexate.
- Surgical operation. Basalioma of the face is completely removed. In this case, the adjacent tissues are captured by about 1-2 centimeters. In the event that cartilage tissue has undergone damage, then it is also subject to resection.
Which ointment should be used for facial skin basalioma?
At the initial stage or with a relapse of the pathology, the following ointments can be used:
- "Omaine ointment".
- "Solcoseryl".
- "Curaderm cream".
- "Iruksol".
- Metwix.
Other treatments
Contraindications for surgery - complex background pathology, advanced age, inability to use anesthesia:
- Cryodestruction. Allows you to remove the basalioma with liquid nitrogen. The destruction of tumor tissue occurs as a result of exposure to too low a temperature. This technique is suitable only for the destruction of small neoplasms that are located on the legs or arms. If the tumor is large, deep infiltration, or located on the face, this method is contraindicated.
- Radiation therapy for basalioma of the facial skin. It can be used as an independent method of treatment, or in combination with others. It can be used to remove formations that are no more than 5 centimeters in size and located on the surface. In this case, the development period should be early, but localization does not matter. This technique is acceptable in the treatment of elderly patients and in the case of an advanced form of the disease. Therapy can be complex, mixed with a drug form of treatment.
- Removal with carbon dioxide or neodymium laser. The use of this technique is possible if the neoplasms are small in size. The method is highly effective, the effectiveness reaches 85%.
- Photodynamic therapy. It is carried out by exposing the basalioma to laser radiation. Prerequires the introduction of a photosensitizer to the patient.
What is photodynamic therapy?
The mechanism of action of the latter method is as follows: tumor cells accumulate a photosensitizer, as a result of exposure to a laser, it provokes the development of tissue necrosis of basal cell carcinoma. Cancer cells die without causing damage to connective tissues. This method in modern medicine is the most popular and widespread. It is often used to remove both primary tumors and recurrent ones, especially those located on the skin of the face.
Forecast
Despite the recurrent nature of this type of tumor, the prognosis is most often favorable. It is possible to achieve a positive result in 80% of cases. If the neoplasm has a local and not advanced form, then timely diagnosis and initiation of therapy can cure it completely.
We examined in this article what a basalioma is.
